Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2011
Influence of timing and oral anticoagulant/antiplatelet therapy on outcomes of patients affected by hip fractures.
Patients undergoing surgical procedures are usually asked to discontinue any anticoagulant/antiplatelet therapy and delay surgery for at least 5 days to reduce the risk of major bleeding and spinal hematoma. ⋯ The "discontinue drug, and delay surgery" strategy is not suitable for patients on anticoagulant (warfarin) therapy affected by a hip fracture.
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Axillary vessel injuries are uncommon and challenging injuries encountered by trauma surgeons. Proximity of this vessel to other adjacent veins including the axillary vein, brachial plexus and the osseous structures of the shoulder and upper arm account for a large number of associated injuries. ⋯ Although uncommon, axillary arterial injuries can result in significant morbidity, limb loss and mortality. Early diagnosis and timely repair of the artery leads to good outcomes.
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Eur J Trauma Emerg S · Oct 2011
Brachial vessel injuries: high morbidity and low mortality injuries.
Reports of arterial injuries from both the civilian and military arenas report the brachial artery as the most frequently injured vessel, accounting for approximately 25-33% of all peripheral arterial injuries. The brachial artery is surrounded by important peripheral nerves -the median, ulnar and radial, and also parallels the humerus and associated veins. Due to its close proximity to these structures, associated nerve and osseous injuries are frequent with residual neuropathy from such nerve injuries, often the main sources of permanent disability. ⋯ The morbidity and mortality rates associated with brachial artery injuries depend on the cause of the injury itself, which vein or tendon is injured, and whether musculoskeletal and nerve injuries are also present. During the last 20 years, amputation associated with upper extremity arterial injuries has decreased to a rate of 3% because of advances in the treatment of shock, the use of antibiotic therapy, and increased surgical experience.
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Eur J Trauma Emerg S · Oct 2011
Risk assessment and management in hand and facial tissue transplantation.
Since hand and facial tissue transplantation are new treatments, risk data must be derived from early reports of the few cases done to date combined with extrapolations from other procedures with similar risks. This manuscript summarizes data from both sources including eight separate studies that measure the real and perceived risks associated with hand and facial tissue transplantation. ⋯ These studies contribute to the growing body of risk data necessary for moving hand and face transplantation into mainstream medicine.
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Eur J Trauma Emerg S · Oct 2011
Lung tissue apoptosis in abdominal hypertension : Apoptosis and necrosis of lung tissue in abdominal hypertension.
The aim of this study was to evaluate lung tissue histopathologic changes and the number of apoptosis with the increase of abdominal pressure. ⋯ The available findings suggest that intra-abdominal pressure greater than 15 mmHg could irreversibly damage pulmonary cells and both coagulation necrosis parameters and the number of apoptosis increase in accordance with the pressure level.